1528241965 NPI number — DULLES EYE ASSOCIATES, P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528241965 NPI number — DULLES EYE ASSOCIATES, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DULLES EYE ASSOCIATES, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528241965
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/08/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19415 DEERFIELD AVE
Provider Second Line Business Mailing Address:
STE 106
Provider Business Mailing Address City Name:
LANSDOWNE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20176-8452
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-723-9633
Provider Business Mailing Address Fax Number:
703-723-9772

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3301 WOODBURN RD STE 204
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ANNANDALE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22003-7302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-208-3299
Provider Business Practice Location Address Fax Number:
703-208-3297
Provider Enumeration Date:
12/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
NASRULLAH
Authorized Official First Name:
ABU
Authorized Official Middle Name:
AHMED
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
703-723-9633

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  0101232401 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: G8480001 . This is a "CAREFIRST" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 14619 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 006310532 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2112890 . This is a "UNITEDHEALTH CARE" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2026 www.npivalidator.com